Obamacare likely to have a rocky start, panel says

Tim Darragh, Of The Morning Call

Small business owners and consumers who are scheduled to begin shopping for health insurance on the Obamacare exchanges in less than two months better buckle up for a bumpy ride, a panel of benefits experts said at an employer roundtable Friday in Bethlehem Township.

Whether it's a speed bump or the proverbial rocky road that makes the ride uncomfortable was up for debate among the panelists, but no one at the forum sponsored by the Lehigh Valley Business Coalition on Healthcare predicted a smooth transition.

Even self-described "optimist" Anthony DaRe, agency principal at BSI Corporate Benefits in Bethlehem, was dismayed that the plans and costs of insurance to be offered on the exchange, or "marketplace," still are unknown in Pennsylvania.

"I guess I would say it's on track," he said, "but I don't know where the tracks are currently located."

Once those plans and costs are known, however, the real difficulty begins, panelists said. Chief among the potential troubles, they said, is "adverse selection" — the decision by young, healthy individuals to forgo buying insurance and paying a $95 fine in 2015. If that happens on a large scale, even with subsidies defraying the cost for low- and middle-income consumers, insurance premiums will rise, causing a downward spiral of fewer buyers and rising costs.

"When they do go live with the campaign to bring in young people, everything points in the opposite direction," DaRe said. "I think it's a foregone conclusion that you're going to have a significant adverse selection."

DaRe also predicted that the Obama administration's campaign to rally young uninsured adults to the exchanges will come up short.

"How many wellness programs work with just a rah-rah speech?" he asked.

Obamacare also limits the difference between what insurance companies can charge the young and old. Because older, sicker buyers won't be required to pay more of the costs as they are now, the price increase will fall on the young, noted Colleen Rackley-Cuda, senior program director at Aetna.

The government side of Obamacare will be run by the U.S. Treasury, Labor, and Health and Human Services departments, requiring unprecedented cooperation by bureaucracies that are not used to working together, said Colleen Bruce of the National Business Coalition on Health.

Consumers' experience with the insurance exchange will depend "entirely on what state you're in," Bruce added. Residents in states such as California, where Obamacare has been embraced by the state government, will find more help than in other states where the reception has been cooler, she said. The problem is increased because the budget for "assisters," who will explain the choices for consumers, is "extremely underfunded," Bruce said.

The panelists agreed that efforts to de-fund Obamacare by congressional Republicans will not succeed, nor will most businesses drop coverage for their employees.

Joe Huxta, manager of Health Care Strategy for Mack Trucks, said health benefits are critical to keeping good employees: "We want to be an employer of choice."

However, unions' discontent with Obamacare could "turn off the money spigot" to Democrats and force them to join the GOP's position, DaRe said. Unions have been unhappy over Obamacare-driven limits placed on part-time workers' hours and future taxes on rich benefits packages.

DaRe said he remains optimistic because the companies he works with will stay focused on their primary business and not let Obamacare get in the way. Eventually, Congress will make adjustments to the law, he predicted.